Can COVID-19 Damage Heart? Cardiologist Answers
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Cases of heart attack and cardiac arrest have increased in covid era with 20-30% of covid patients having significant heart problems.

Dr Nikesh Jain, Consultant Cardiologist at Jaslok Hospital and Research Centre explains how Covid can damage the heart in multiple ways –

1. Heart Attacks

It occurs due to 100% blockage of heart vessels by blood clots over pre-existing heart blockages. Covid infection causes plaque instability and increases tendency of blood to clot, resulting in heart attack.

2. Myocardial necrosis

Covid can directly infect heart muscle cells and blockage of small vessels of heart causing heart pumping to decrease. This type of injury mimics heart attack on blood test and ECG, though the larger heart vessels may not show any blockage.

3. Myocarditis

This is a severe form of myocardial necrosis, which is due to an exaggerated immune response to covid infection. It is associated with worst prognosis, causing decreased heart pumping, cardiogenic shock, heart rhythm problems and cardiac arrest.

4. Stress cardiomyopathy (Takostubo syndrome)

This type of pattern also mimics heart attack, but heart vessels may be normal. Heart muscles become weak secondary to the stress of inflammatory response to covid infection.

Patients who develop heart attack should be treated on urgent basis by thrombolysis or Primary Angioplasty – coronary angiography followed heart vessel stenting.

Treatment of other types of heart involvement is supportive care – treating underlying infection, blood thinner injections, supporting blood pressure or even heart support devices like ECMO.

Patients who are at high risk should be preferable admitted and monitored for signs of heart involvement.

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